Form M010 OR "Maintenance & Repair Request Form - Multifamily Nw - Sample" - Oregon

ADVERTISEMENT
ADVERTISEMENT

Download Form M010 OR "Maintenance & Repair Request Form - Multifamily Nw - Sample" - Oregon

Download PDF

Fill PDF online

Rate (4.3 / 5) 14 votes
OREGON
M INTEN NCE & REP IR REQUEST
D TE
PROPERTY N ME / NUMBER
__________________________________________
_________________________________________________________________________________________________________________________________________________________________
RESIDENT N ME(S)
___________________________________________________________________________
___________________________________________________________________________
__________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
__________________________________________________________________________
UNIT NUMBER
STREET DDRESS
___________________________________
__________________________________________________________________________________________________________________________________________________________________________
CITY
ST TE
ZIP
___________________________________________________________________________________________________________________________________________________
___________________________________
____________________________________________________________
SAMPLE
SAMPLE
SAMPLE
BEST W Y TO CONT CT ME: PHONE
TIMES:
TO
______________________________________________________________________________
___________________________________
___________________________________
SAMPLE
SAMPLE
EM IL
________________________________________________________________________________
SAMPLE
SAMPLE
SAMPLE
SAMPLE
X
X
X
X
ENTRY CONCERNS: MINORS
YES
NO
PETS
YES
NO IF YES, NUMBER & TYPE
____________________________________________________________________________________
SAMPLE
OTHER ENTRY CONCERNS
________________________________________________________________________________________________________________________________________________________________________________
SAMPLE
TYPE OF MAINTENANCE OR REPAIR NEEDED:
SAMPLE
X
X
X
X
X
X
Heating
Appliance
Doors / Windows
Plumbing
Electric
Other
_______________________________________________________________
Exact nature of problem and cause (if known). Be SPECIFIC!
SAMPLE
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Resident agrees that this written request authorizes Owner/Agent to enter the Premises without notice at reasonable times to perform the
repairs/maintenance. This authorization expires after seven (7) days unless the repairs/maintenance are in progress and Owner/Agent is making
reasonable effort to complete the repairs/maintenance, in which event Resident authorizes entry at reasonable times in excess of seven (7) days
until such repairs/maintenance are completed.
By signing this request, Resident also agrees that Owner/Agent’s staff may conduct a preventative maintenance inspection while in the unit and,
to the extent practical, do any necessary repairs. If it is not practical to perform the repairs in conjunction with the repairs requested by Resident
under this Maintenance & Repair Request, a new notice of entry will be given for the new repair work.
X
RESIDENT
D TE
__________________________________________________________________________________________________________________________________________________
____________________________________________________
SAMPLE
OWNER/AGENT’S RESPONSE:
SAMPLE
SAMPLE
The repairs/maintenance requested above were performed on:
by:
____________________________________________________
___________________________________________________________________________________________
The following work was completed:
SAMPLE
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
SAMPLE
SAMPLE
X
X
Smoke Alarm(s) checked Date
Carbon Monoxide Alarm(s) checked (if applicable) Date
_____________________________________________
_____________________________________________
X
OWNER/ GENT
D TE
_______________________________________________________________________________________________________________________________________
____________________________________________________
ON SITE
RESIDENT
M IN OFFICE (IF REQUIRED)
OREGON
M INTEN NCE & REP IR REQUEST
D TE
PROPERTY N ME / NUMBER
__________________________________________
_________________________________________________________________________________________________________________________________________________________________
RESIDENT N ME(S)
___________________________________________________________________________
___________________________________________________________________________
__________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
__________________________________________________________________________
UNIT NUMBER
STREET DDRESS
___________________________________
__________________________________________________________________________________________________________________________________________________________________________
CITY
ST TE
ZIP
___________________________________________________________________________________________________________________________________________________
___________________________________
____________________________________________________________
SAMPLE
SAMPLE
SAMPLE
BEST W Y TO CONT CT ME: PHONE
TIMES:
TO
______________________________________________________________________________
___________________________________
___________________________________
SAMPLE
SAMPLE
EM IL
________________________________________________________________________________
SAMPLE
SAMPLE
SAMPLE
SAMPLE
X
X
X
X
ENTRY CONCERNS: MINORS
YES
NO
PETS
YES
NO IF YES, NUMBER & TYPE
____________________________________________________________________________________
SAMPLE
OTHER ENTRY CONCERNS
________________________________________________________________________________________________________________________________________________________________________________
SAMPLE
TYPE OF MAINTENANCE OR REPAIR NEEDED:
SAMPLE
X
X
X
X
X
X
Heating
Appliance
Doors / Windows
Plumbing
Electric
Other
_______________________________________________________________
Exact nature of problem and cause (if known). Be SPECIFIC!
SAMPLE
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Resident agrees that this written request authorizes Owner/Agent to enter the Premises without notice at reasonable times to perform the
repairs/maintenance. This authorization expires after seven (7) days unless the repairs/maintenance are in progress and Owner/Agent is making
reasonable effort to complete the repairs/maintenance, in which event Resident authorizes entry at reasonable times in excess of seven (7) days
until such repairs/maintenance are completed.
By signing this request, Resident also agrees that Owner/Agent’s staff may conduct a preventative maintenance inspection while in the unit and,
to the extent practical, do any necessary repairs. If it is not practical to perform the repairs in conjunction with the repairs requested by Resident
under this Maintenance & Repair Request, a new notice of entry will be given for the new repair work.
X
RESIDENT
D TE
__________________________________________________________________________________________________________________________________________________
____________________________________________________
SAMPLE
OWNER/AGENT’S RESPONSE:
SAMPLE
SAMPLE
The repairs/maintenance requested above were performed on:
by:
____________________________________________________
___________________________________________________________________________________________
The following work was completed:
SAMPLE
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
SAMPLE
SAMPLE
X
X
Smoke Alarm(s) checked Date
Carbon Monoxide Alarm(s) checked (if applicable) Date
_____________________________________________
_____________________________________________
X
OWNER/ GENT
D TE
_______________________________________________________________________________________________________________________________________
____________________________________________________
ON SITE
RESIDENT
M IN OFFICE (IF REQUIRED)